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    From Co-WIN to U-WIN: Indian Govt Plans to Digitise Immunisation Programme Amid Unaddressed Privacy Risks to Health Data

    Remember Co-WIN, India’s COVID-19 vaccination portal? Co-WIN is now being transformed into U-WIN facilitating vaccination services under the National Immunisation Programme, the Union Health Secretary Apurva Chandra announced during a Digital Health event on May 29, as part of the 77th World Health Assembly in Geneva.

    Indicating that the portal will be linked to several other sources of health records, the Secretary also stated that U-WIN “will aid in linking and providing immunization record of 30 million new born and mothers every year followed by Anganwadi and school health record.” The discussion primarily focused on how digital public infrastructure can improve access to healthcare services.

    It’s been a long time since U-WIN made news:

    As part of the plans to digitise the Universal Immunisation Programme (UIP), in January 2023, the government initiated a pilot project to digitise vaccination records and require people to register on the U-WIN portal in select two districts of every State and Union Territory.

    In September 2022, R S Sharma, then CEO of the National Health Authority (NHA), informed that the government was planning to repurpose digital health platforms Arogya Setu and Co-WIN to address certain health issues in the country, adding that Co-WIN would be used for carrying out the 12 essential vaccination programs under the Universal Immunisation Programme. He said that they were “repurposing it [Co-WIN] to become the small doctor’s Health Management Information System (HMIS).”

    The government has pitched U-WIN as a replica of Co-WIN to serve as a one-stop source for all information on mother and child’s immunisation. According to an Economic Times report, once the U-WIN portal is fully implemented, it will maintain records of pregnant women, delivery outcomes, vaccination status and plans for routine immunisation sessions.

    What will it be used for?

    1. As reported earlier, the U-WIN portal will be linked to labour rooms, government and private hospitals to extract the relevant data on expecting mothers and newborn babies. The Union government had said that the portal would be used to register every pregnant woman, record delivery details, register every newborn baby and track their vaccination journey.
    2. The U-WIN portal is also expected to facilitate booking appointments for vaccines in the nearest health centre, and alert users through reminders and notifications via SMS.
    3. Like Co-WIN, digital certificates of vaccination will be issued through the U-WIN portal, and are expected to be stored in DiGiLocker.
    4. The government is planning to track registrations of every pregnant woman individually for vaccination and upcoming doses, and for following up on drop-outs. Healthcare workers are expected to track these sessions on a “real-time basis.”
    5. Plans to issue immunisation cards linked to the ABHA ID (Ayushman Bharat Heath Account) to each pregnant woman and children are also on the charts. Through these cards, details of past vaccinations can maintained in a common database, which will be accessed by all state governments, to track and vaccinate beneficiaries.

    However, there are many things unknown about U-WIN:

    In February 2023, when the media reported about the Himachal Pradesh government’s decision to implement all state vaccination programmes through the U-WIN portal, there was little to no information in the public domain clarifying whether those availing vaccine facilities can choose not to register for the programme.

    The absence of official documentation on the Ministry’s website about such a significant health initiative prompted us to file an RTI for details about the U-WIN programme. In two separate RTIs filed on February 8, we inquired about the status of the pilot project; whether it was mandatory for people to sign up for U-WIN to get vaccinated and whether there was any official paper/document notifying the public; and what the objectives of the undertaken project are.

    We also inquired about the kind of data that will be collected from the beneficiaries during registration and during their vaccination journey; the list of portals/websites/platforms that the U-WIN platform will be linked to and whether private vaccine companies are involved in implementing any part of the project.

    The ministry responded to only three of the above-mentioned queries. It listed out the districts where the pilot project is being carried out and informed that “It is not compulsory to get registered on the U-WIN platform for pregnant women and newborn babies to access vaccination facilities.”

    Regarding the involvement of private companies, the Ministry stated, “Private vaccine companies/firms are not involved in the implementation of U-WIN pilot project.”

    We filed another set of RTIs covering the following questions:

    • Did the ministry release a policy paper or a consultation paper or even an official press release detailing the launch and development of U-WIN? If yes, details thereof.
    • Is U-WIN a part of the India Health Stack project? If yes, details thereof.
    • What types of data, information will be collected from individuals registering on the U-WIN portal?
    • Is the data/information of individuals registering for U-WIN collected and stored in the U-WIN portal? If yes, for how long?
    • Will the U-WIN data be shared with other ministries?

    The Ministry did not provide answers to these questions.

    Why is it concerning?

    The government has been pushing to make health data and services interoperable through Ayushman Bharat, Co-WIN, and the Unified Health Interface project. But, is this data-linking process happening with people’s informed consent? And is U-WIN another layer of database to further the IndiaStack goals? 

    The government has collected sensitive personal data of millions of Indian citizens through Co-WIN and the Ayushman Bharat programme. One must not forget that the Co-WIN portal is already under scrutiny for a major data leak which happened last year, casting serious doubts over government’s claims that our data is secure. Now, when the government is repurposing Co-WIN for other immunisation programmes, which means adding or linking more data with the same portal, it’s worth questioning if there’s a limit to the purposes for which citizens’ health data can be used, especially in the context of insufficient safeguards to privacy of such personal data.

    Also Read:

    The post From Co-WIN to U-WIN: Indian Govt Plans to Digitise Immunisation Programme Amid Unaddressed Privacy Risks to Health Data appeared first on MEDIANAMA.

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